The Evolution of Breast Imaging

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification for enrollments starting after February 24, 2023:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Breast Sonography: 0.50
Patient Care: 0.50
Patient Interactions and Management: 0.50

Mammography: 0.50
Procedures: 0.50
Mammographic Positioning, Special Needs, and Imaging Procedures: 0.50

Magnetic Resonance Imaging: 0.25
Procedures: 0.25
Body: 0.25

Sonography: 0.25
Procedures: 0.25
Superficial Structures and Other Sonographic Procedures: 0.25

Outline

1. Introduction
2. Evolution of Breast Imaging Technique
   1. Direct Exposure Mammography
   2. Xeromammography
   3. Screen-Film Mammography
   4. Advent of Screening Mammography
   5. The Oblique View and Specialized Mammographic Views
   6. Standardized Reporting and Outcomes
   7. Breast Density Legislation
3. Digital Mammography
   1. Thermography
4. Complementary Breast Imaging Technologies
   1. Breast US
   2. Breast MR Imaging
5. Breast Intervention
   1. Freehand Localization
   2. Grid Localization
6. Percutaneous Breast Biopsy for Nonpalpable Lesions
   1. Fine-Needle Aspiration Biopsy
   2. Core Biopsy
7. A Look to the Future
   1. Digital Breast Tomosynthesis
   2. Breast MR Spectroscopy and Diffusion
   3. Abbreviated Breast MR Screening
   4. Alternative Imaging Modalities
8. Conclusion

Objectives

Upon completion of this course, students will:

1. understand options for diagnosing breast cancer prior to breast imaging becoming available to patients
2. recall physicians associated with early breast imaging techniques
3. differentiate between x-ray equipment used for breast roentgenograms in the early 1920s and 1930s
4. describe Egan’s mammography positioning techniques
5. explain imaging challenges associated with underexposed breast images
6. specify the origin of the xeromammography process
7. name the inherent parameters associated with the xeroradiographic process
8. list challenges associated with the xeroradiographic process
9. list advantages of breast compression
10. know the year in which the oblique mammographic view was introduced
11. specify the benefits of two-view mammographic screening
12. describe the best mammographic view for visualizing lesions in the augmented breast
13. state the benefits of magnification mammography
14. understand the factors necessary for successful mammography
15. name the first structured reporting language for imaging
16. list the components of the BI-RADS reporting system
17. specify imaging modalities that use the BI-RADS standardized auditing approach
18. list challenges associated with digital mammographic imaging
19. articulate advantages to converting to digital mammography
20. express the number of facilities and units in the United States using full-field digital mammography
21. understand the benefits of ultrasound coupled with mammography for evaluating breast masses
22. list barriers to widespread adoption of ultrasound as a breast screening tool
23. name early successes with diagnostic applications of breast MR
24. differentiate between diagnostic and screening breast MR imaging
25. state the most sensitive modality for breast imaging
26. name the first physician to perform freehand breast needle localization
27. describe breast needle placement in order to reduce chance of pneumothorax
28. list the modalities with which wire localization can be performed
29. note both patient and society benefits of image-guided percutaneous breast biopsy
30. understand the role of image-guided percutaneous biopsy as is relates to tissue diagnosis
31. explain when and where fine-needle aspiration was first performed
32. list the advantages of core biopsy over fine-needle aspiration
33. discuss data in regard to digital breast tomosynthesis
34. define MR spectroscopy
35. understand the potential applications of diffusion-weighted imaging